The Journal of antimicrobial chemotherapy · 2025
Results from the Survey of Antibiotic Resistance (SOAR) 2018-21 in Kuwait and the United Arab Emirates: data based on CLSI, EUCAST (dose-specific) and pharmacokinetic/pharmacodynamic (PK/PD) breakpoints.
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Torumkuney Didem, Mokaddas Eiman, Weber Stefan, Morrissey Ian, Keles Nergis, Manoharan Anand
Аннотация
OBJECTIVES: To determine antibiotic susceptibility of Streptococcus pneumoniae and Haemophilus influenzae from community-acquired respiratory tract infections in Kuwait and United Arab Emirates (UAE), collected in 2018-21.
METHODS: MICs determined by CLSI broth microdilution; susceptibility data interpreted using CLSI and EUCAST breakpoints.
RESULTS: A total of 49 S. pneumoniae and 79 H. influenzae and 49 S. pneumoniae and 34 H. influenzae were collected from Kuwait and UAE, respectively. Of the pneumococci, 26.5% (UAE) and 20.4% (Kuwait) were penicillin susceptible by CLSI oral/EUCAST low-dose breakpoints; by CLSI intravenous/EUCAST high-dose administration, 95.9% (UAE) and 85.7% (Kuwait) were susceptible. Similar susceptibility was observed to ceftriaxone, amoxicillin/clavulanic acid, amoxicillin and cefotaxime (CLSI: 73.5%-93.9%) but lower to other cephalosporins, tetracyclines, macrolides and trimethoprim/sulfamethoxazole. Fluoroquinolones were ≥98.0% susceptible (CLSI/EUCAST high-dose). Compared with CLSI, activity was similar by EUCAST high-dose or pharmacokinetic/pharmacodynamic (PK/PD) breakpoints with few exceptions. Of the H. influenzae isolates, 17.7% (Kuwait) and 8.8% (UAE) carried β-lactamases. Significant differences in H. influenzae susceptibility (CLSI) were found for amoxicillin/clavulanic acid (81.0% Kuwait/97.1% UAE) and fluoroquinolones (UAE: levofloxacin 88.2%, moxifloxacin 82.4%; Kuwait: both 98.7%). Susceptibility was overall >91.2% (CLSI) except for ampicillin (81.0% Kuwait) and trimethoprim/sulfamethoxazole (47.1% UAE/55.7% Kuwait). EUCAST susceptibility was similar, except for cefuroxime. PK/PD susceptibility was similar to CLSI, but lower for cefaclor, cefuroxime and macrolides.
CONCLUSIONS: Pneumococci were susceptible to fluoroquinolones (>98%), amoxicillin and amoxicillin/clavulanic acid (>79%-94%), ceftriaxone and cefotaxime (>73%-94%). Susceptibility was lower to oral/low-dose penicillin (20%-27%), macrolides (33%-51%), tetracyclines (53%-59%) and trimethoprim/sulfamethoxazole (33%-61%). Susceptibility was generally >80% in H. influenzae except for trimethoprim/sulfamethoxazole (47%-56%).
METHODS: MICs determined by CLSI broth microdilution; susceptibility data interpreted using CLSI and EUCAST breakpoints.
RESULTS: A total of 49 S. pneumoniae and 79 H. influenzae and 49 S. pneumoniae and 34 H. influenzae were collected from Kuwait and UAE, respectively. Of the pneumococci, 26.5% (UAE) and 20.4% (Kuwait) were penicillin susceptible by CLSI oral/EUCAST low-dose breakpoints; by CLSI intravenous/EUCAST high-dose administration, 95.9% (UAE) and 85.7% (Kuwait) were susceptible. Similar susceptibility was observed to ceftriaxone, amoxicillin/clavulanic acid, amoxicillin and cefotaxime (CLSI: 73.5%-93.9%) but lower to other cephalosporins, tetracyclines, macrolides and trimethoprim/sulfamethoxazole. Fluoroquinolones were ≥98.0% susceptible (CLSI/EUCAST high-dose). Compared with CLSI, activity was similar by EUCAST high-dose or pharmacokinetic/pharmacodynamic (PK/PD) breakpoints with few exceptions. Of the H. influenzae isolates, 17.7% (Kuwait) and 8.8% (UAE) carried β-lactamases. Significant differences in H. influenzae susceptibility (CLSI) were found for amoxicillin/clavulanic acid (81.0% Kuwait/97.1% UAE) and fluoroquinolones (UAE: levofloxacin 88.2%, moxifloxacin 82.4%; Kuwait: both 98.7%). Susceptibility was overall >91.2% (CLSI) except for ampicillin (81.0% Kuwait) and trimethoprim/sulfamethoxazole (47.1% UAE/55.7% Kuwait). EUCAST susceptibility was similar, except for cefuroxime. PK/PD susceptibility was similar to CLSI, but lower for cefaclor, cefuroxime and macrolides.
CONCLUSIONS: Pneumococci were susceptible to fluoroquinolones (>98%), amoxicillin and amoxicillin/clavulanic acid (>79%-94%), ceftriaxone and cefotaxime (>73%-94%). Susceptibility was lower to oral/low-dose penicillin (20%-27%), macrolides (33%-51%), tetracyclines (53%-59%) and trimethoprim/sulfamethoxazole (33%-61%). Susceptibility was generally >80% in H. influenzae except for trimethoprim/sulfamethoxazole (47%-56%).
Предметные рубрики MeSH
HumansKuwaitMicrobial Sensitivity TestsStreptococcus pneumoniaeAnti-Bacterial AgentsHaemophilus influenzaeUnited Arab EmiratesCommunity-Acquired InfectionsRespiratory Tract InfectionsAdultMiddle AgedMaleFemaleYoung AdultAdolescentHaemophilus InfectionsChildChild, PreschoolDrug Resistance, BacterialAgedInfantPneumococcal Infections